Can a Rescuer Gazing Point Intervention Improve the Depth of Chest Compressions in Hands-only Cardiopulmonary Resuscitation? A Randomized Simulation Study

Sang-Kuk HAN; Pil-Cho CHOI; Chong-Kun HONG; Dong-Hyuk SHIN; Ji-Ung NA; Hyun-Jung LEE; Seong-Youn HWANG; Jun-Hwi CHO

PURPOSE:

The aim of this study was to evaluate whether a simple verbal instruction regarding the rescuer gazing point can improve the depth of chest compressions (CCs) in the hands-only cardiopulmonary resuscitation (CPR).

METHODS:

Participants who took part in basic life support training courses for lay-rescuers were eligible for inclusion in this prospective, single-blinded, cluster randomized controlled study. After the training courses, both the control and the intervention groups performed the hands-only CPR for two minutes on a manikin placed on the ground. Immediately prior to CCs, instructors provided the intervention group with brief verbal instructions to look in the opposite direction of the adducted arm after placing the heel of the hand on the mid-sternum.

RESULTS:

One hundred and twenty-two participants (61 for each group) were enrolled in this study. The intervention group showed significantly deeper CCs than the control group (47.9±8.2 mm vs. 43±8.4 mm, p<0.01); however, there were no significant differences between the two groups in the quality of chest recoil, CC rate, or duty cycle of CCs. However, the frequency of incorrect hand position was higher in the intervention group when compared with the control group (10.3 [2.3-35.7] vs. 5.7 [0-33.0], p=0.036)

CONCLUSION:

Instructions to look in the opposite direction of the adducted arm during CCs improved the mean depth of CCs without significant adverse effects on the quality of recoil, CC rate, or duty cycle of CCs. However, the frequency of incorrect hand position was higher in the intervention group than the control group.

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